- Patient Comments: Heel Spurs - Treatment
- Patient Comments: Heel Spurs - Symptoms
- Patient Comments: Heel Spurs - Causes
Heel spurs (calcaneal spurs) facts
- A heel spur is a pointed bony outgrowth of the heel bone (the calcaneus bone).
- The build-up of calcium deposits under the heel bone causes heel spurs.
- Heel spurs under the sole of the foot (plantar area) are associated with plantar fasciitis (inflammation of the plantar fascia ligament at the bottom of the foot).
- Heel pain is a common symptom of heel spurs.
- Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases.
- Heel spurs are treated by anti-inflammatory medications, orthotics, and other measures that decrease the associated inflammation and avoid reinjury.
What is a heel spur? What are heel spur symptoms?
A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). Chronic local inflammation at the insertion of soft-tissue tendons or plantar fascia is a common cause of bone spurs (osteophytes). Heel spurs can be located at the back of the heel or under the heel, beneath the arch of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and heel pain made worse while pushing off the ball of the foot.
How do heel spurs relate to plantar fasciitis? What causes heel spurs?
Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (plantar fasciitis), the "bowstring-like" ligament stretching underneath the sole that attaches at the heel. Plantar heel spurs cause localized tenderness and heel pain made worse when stepping down on the heel.
Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases that cause arthritis (inflammation of the joints), such as reactive arthritis (formerly called Reiter's disease), ankylosing spondylitis, and diffuse idiopathic skeletal hyperostosis (DISH). It is important to note that heel spurs may cause no symptoms at all and may be incidentally discovered during X-ray exams taken for other purposes.
How do health care professionals diagnose heel spurs?
Heel spurs are diagnosed based on the history of heel pain and tenderness localized to the area of bony involvement. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on hard surfaces, like tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
What are heel spur treatment options? Are there any home remedies for heel spurs?
Heel spurs are treated by measures that decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Anti-inflammatory medications, such as naproxen (Aleve) and ibuprofen (Advil), or injections of cortisone, are often helpful.
Orthotic devices or shoe inserts are used to take pressure off plantar spurs (donut-shaped insert), and heel lifts can reduce stress on the Achilles tendon to relieve painful bone spurs at the back of the heel. Similarly, sports running shoes with soft, cushioned soles can be helpful in reducing irritation of inflamed tissues from heel spurs. Infrequently, surgery is performed on chronically inflamed spurs.
What is the prognosis (outlook) of heel spurs?
The long-term outlook is generally good. The inflammation usually responds to conservative, nonsurgical treatments, like anti-inflammatory drugs and orthotics. Infrequently, surgical intervention is necessary.
Is it possible to prevent heel spurs?
Treating any underlying associated inflammatory disease can prevent heel spurs.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
"Plantar Fasciitis and Bone Spurs." June 2010. American Academy of Orthopaedic Surgeons. <https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs>.
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Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce mild to moderate pain, inflammation, and fever. Ibuprofen works by blocking an enzyme that makes prostaglandin (a hormone-like substance that participates in a variety of body functions), which results in lower levels of prostaglandins in the body. Lower levels of prostaglandins reduce pain, inflammation, and fever.
Ibuprofen is prescribed to treat diseases and conditions that cause mild to moderate pain, fever, and inflammation. For example, Pain from strains and sprains; pain from cuts, scrapes, and puncture wounds; muscle aches and pains; tooth pain; common cold; mild headache; some arthritis conditions; joint pain; and to reduce fever.
Common side effects of ibuprofen include, diarrhea, constipation, nausea, heartburn, belly pain, drowsiness, headaches, tinnitus (ringing in the ears), and mild rash.
More serious side effects and adverse effects include, increased bleeding after injury, stomach ulcers, impaired kidney function, severe allergic reaction (anaphylaxis), blood clots, heart attack, heart failure, and high blood pressure.
The maximum dose prescribed under a doctor's care is 3.2 g daily. Otherwise, the over-the-counter (OTC) maximum daily dose is 1.2 g daily. Dosage depends upon the age, weight, and any current medical conditions of the patient. Several drugs interact with ibuprofen so check with your doctor, pharmacist, or other health care professional with questions in regard to this drug. Doctors don't know if it is safe to take ibuprofen if your are pregnant, therefore it is not recommended if you are pregnant. According to the American Academy of Pediatrics, ibuprofen is safe to take while breastfeeding.
REFERENCE: FDA Prescribing Information.
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